Antiepileptic drug poisoning: Three-year experience

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dc.contributor.authorGunaydin, Yahya Kemal
dc.contributor.authorAkilli, Nazire Belgin
dc.contributor.authorDundar, Zerrin Defne
dc.contributor.authorKoylu, Ramazan
dc.contributor.authorSert, Ekrem Taha
dc.contributor.authorCekmen, Bora
dc.contributor.authorAkinci, Emine
dc.date.accessioned2024-02-23T14:16:23Z
dc.date.available2024-02-23T14:16:23Z
dc.date.issued2015
dc.departmentNEÜen_US
dc.description.abstractIntroduction: Antiepileptic drugs, which are also called anticonvulsants, are used in the therapy and prophylaxis of epileptic seizures. The purpose of this paper was to investigate the relevant epidemiological data and to determine which of these drugs was the most frequent cause of intoxication. Another purpose of this study was to determine the neurological, cardiac, and biochemical problems caused by antiepileptics. Material and method: This retrospective study included 95 consecutive patients under 18 years of age with antiepileptic intoxication, presenting to and being followed-up in, the Toxicology Unit between January 2010 and February 2013. The data were obtained by screening the patient files. Results: Of the cases, 67 (70.5%) were self-poisoned by first generation antiepileptics (FGAEs) and 28 (29.5%) by second generation antiepileptics (SGAEs). The Glasgow Coma Scale (GCS) scores and the serum lactate levels of the patients poisoned by FGAEs and SGAEs on admission to emergency department were 15 (25th: 12; 75th: 15; 95th: 15; IQR: 3) and 1.9 (25th: 1.4; 75th: 3.1; 95th: 5.6; IQR: 1.7), and 15 (25th: 14.3; 75th: 15; 95th: 15; IQR: 0.75) and 1.07 (25th: 0.9; 75th: 1.6; 95th: 5.5; IQR: 0.71), respectively. The serum lactate levels of patients poisoned by FGAEs were significantly higher (p < 0.001). Among the cases poisoned by carbamazepine, the most frequent cause of intoxication, the GCS score was significantly lower and serum lactate level was significantly higher in the group with high serum levels of carbamazepine (p = 0.004 and p < 0.001, respectively). In cases poisoned by valproic acid (VPA), the second frequent cause of intoxication, there was neither a significant association between the serum VPA level and the GCS score, nor between the serum lactate level and the systolic blood pressure (p = 0.470, p = 0.897, and p = 0.088, respectively). However, there was a positive correlation between the serum VPA level and the serum ammonia level (kk = 0.742, p < 0.001). Conclusion: First generation antiepileptics are more toxic than SGAEs. In patients with serum carbamazepine level, particularly those over 30 mg/L, serious disorders of consciousness, cardiovascular toxicity, and metabolic disorders may occur. In VPA intoxication, there is a positive correlation between the serum VPA levels and ammonia levels. On account of this finding, one should be more careful about hyperammonemic hepatic encephalopathy as the serum VPA level rises. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license.en_US
dc.identifier.doi10.1016/j.toxrep.2014.11.004
dc.identifier.endpage62en_US
dc.identifier.issn2214-7500
dc.identifier.pmid28962337en_US
dc.identifier.scopus2-s2.0-84924070704en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage56en_US
dc.identifier.urihttps://doi.org/10.1016/j.toxrep.2014.11.004
dc.identifier.urihttps://hdl.handle.net/20.500.12452/12648
dc.identifier.volume2en_US
dc.identifier.wosWOS:000218510700006en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Bven_US
dc.relation.ispartofToxicology Reportsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAntiepilepticen_US
dc.subjectDrugen_US
dc.subjectPoisoningen_US
dc.titleAntiepileptic drug poisoning: Three-year experienceen_US
dc.typeArticleen_US

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